FAQs on COVID-19 and urogenital diseases

This is the 3079th article of Da Yi Xiao Hu

If you ask your friends, the most popular word in the world in 2020, there should be no doubt that the new crown is the first. Until now, the new coronavirus pneumonia (COVID-19) caused by the 2019 novel coronavirus (2019-nCOV) at the end of 2019 is still raging around the world. In the United States, the death toll caused by it even exceeds the number of deaths in the country during World War II. Today, we will share with you the relevant knowledge about the new coronavirus pneumonia (COVID-19) and its impact on the urogenital system in the form of a small question and answer.

1. What are the main clinical manifestations of novel coronavirus pneumonia (COVID-19)?

Answer: The clinical manifestations of COVID-19 are diverse. Some patients with mild symptoms may be asymptomatic. The most common symptoms for other patients are fever, dry cough, myalgia, fatigue, etc. Severe cases mainly cause severe respiratory symptoms, and even progressive respiratory failure leading to death. Some patients show extra-pulmonary symptoms such as diarrhea, heart function damage, liver and kidney function damage, etc.

2. What are the extrapulmonary manifestations of novel coronavirus pneumonia (COVID-19)?

Answer: Research by medical experts and researchers shows that in addition to respiratory system lesions, patients with new coronavirus pneumonia (COVID-19) may also develop lesions in the cardiovascular system, digestive system, urogenital system, etc.

① Cardiovascular system

Patients with novel coronavirus pneumonia may experience cardiovascular events such as acute myocardial damage, arrhythmias, heart failure, and coronary atherosclerotic heart disease. Friends who have relatives with underlying heart diseases at home should pay special attention and do a good job in preventing and controlling the novel coronavirus.

② Digestive system

Patients with COVID-19 may also experience abnormal liver function, and the proportion of abnormal liver function is higher in severe patients. Due to the impact of the new coronavirus (2019-nCOV) on the gastrointestinal mucosa, some infected people may experience symptoms such as indigestion and diarrhea.

③ Urogenital system

The impact of 2019-nCOV on the urinary system mainly causes acute kidney injury (AKI), which can cause proteinuria and microscopic hematuria in mild cases, and renal failure in severe cases. Therefore, some patients with severe new coronavirus pneumonia need hemodialysis. In addition to the impact on the kidneys, 2019-nCOV can also damage the testicles and affect sperm production, leading to hypogonadism and infertility. This may be quite frightening for you, right?

④ Blood system

Studies have confirmed that patients with novel coronavirus pneumonia may experience a decrease in blood lymphocyte counts, and 20% of patients have abnormal coagulation function.

⑤ Other extrapulmonary manifestations

Some patients with COVID-19 experience conjunctivitis, acute oculomotor nerve palsy, loss of smell and taste, etc. After reading this, do you feel that the food you are eating is not so delicious anymore?

3. How does 2019-nCOV attack the urogenital system?

A: This paragraph is too professional and a bit difficult to understand. Those who are not interested in becoming a doctor can skip it. The new coronavirus (2019-nCOV) uses angiotensin converting enzyme 2 (ACE2) as a receptor, and invades cells through endosomal or non-endosomal pathways with the help of different host cell proteases, and has a structural basis for directly causing damage to extrapulmonary organs or tissues. ACE2 is a membrane-bound aminopeptidase that is expressed not only in alveolar epithelial cells, but also in multiple extrapulmonary tissues and organs such as the heart, liver, intestines, pancreas, kidneys, testicles, ovaries and uterus. In layman's terms, 2019-nCOV attacks host cells by binding to ACE2. And our kidneys and testicles are also indiscriminately attacked because of ACE2.

4. What are other causes of acute kidney injury (AKI) in patients with COVID-19?

A: When the novel coronavirus (2019-nCOV) enters the human body, it will cause the body to produce a large amount of cytokines to fight it. The resulting cytokine storm-induced immune damage can cause acute kidney injury. In addition, severe novel coronavirus pneumonia (COVID-19) hypoxemia and some COVID-19 treatment drugs and methods can cause AKI.

5. How to prevent the impact of 2019-nCOV on the urinary and reproductive system?

A: Haha, as long as you don't get COVID-19, you're done. So, although I've heard it countless times over the past year, I still have to repeat it here: wear a mask, wash your hands frequently, go out less, don't get together, pay attention to your work and rest schedule, don't stay up late...

References

［1］Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China［J］． N Engl J Med, 2020, 382(18): 1708-1720． DOI: 10.1056/NEJMoa2002032.

［2］ Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus infected pneumonia in WuHan, China［J］． JAMA, 2020,323(11):1061 DOI: 10.1001/jama． 2020．1585．

[3] Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS CoV 2pneumonia in WuHan, China: a single centered, retrospective, observational study［J］． Lancet Respir Med, 2020, 8(5):475-481． DOI: 10.1016/S2213-2600(20)30079 -5．

［4］Hoffmann M, Kleine-Weber H, Kruger N, et al. The novel coronavirus 2019(2019-nCOV) uses the SARS coronavirus receptor ACE2 and the cellular protease TMPRSS2 for entry into target cells［J/OR］． bioRxiv,2020(2020-01-31)［2020-04-06］． https:// www.biorxiv.org/content/10.1101/2020.01.31.929042v1. DOI: 10.1001/2020.01.31.929042．

［5］Ma L, Xie W, li D, et al. Effect of SARS CoV 2 infection upon male gonadal function: a single centered based study［J/OL］． medRxiv,2020(2020-03-31) [2020-04-06]． https:// www.medrxiv.org/content/10.1101/2020.03.21.20037267v2. DOI: 10.1001/2020.03.21.20037267．

[6] Wang Jiayi, Du Lingyao, Tang Hong. Research progress on 2019 novel coronavirus and extrapulmonary tissue damage[J]. Chinese Journal of Infectious Diseases. 2021,39(1): 49-53.

Author: Shao Enming and Bao Juan